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Comment by w10-1 | Hacker News Reader

"only as a bridge to using electricity"

The key point is that the AED (automatic electric defibrillator) will tell you if you have a shockable rhythm.

Many modern AED's can be used by untrained people, so if you see a cardiac arrest, find the nearest AED and deliver it and/or follow its (brief) instructions. Once you know this, you'll start tracking the last one you saw, and you'll find them more ubiquitous than you realized (and start advocating for one in your office).

(And if you are doing CPR, the breathing part is less important than the chest compressions. Blood flow is more important than oxygenation. But always/only follow current guidelines/training.)

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> (And if you are doing CPR, the breathing part is less important than the chest compressions. Blood flow is more important than oxygenation. But always/only follow current guidelines/training.)

The problem is that this advice is situational.

If electrocution is what caused the cardiac arrest, it is much better to give breaths than compressions. The heartbeat system resets itself before the respiratory system. The problem is then that the heart is back, uses up all its energy reserves, but there is no oxygen to replenish and the heart goes back into arrest.

> If electrocution is what caused the cardiac arrest, it is much better to give breaths than compressions. The heartbeat system resets itself before the respiratory system. The problem is then that the heart is back, uses up all its energy reserves, but there is no oxygen to replenish and the heart goes back into arrest.

Can you provide a reference or citation to this claim and practice?

It is always much better to give "conventional CPR" (breaths and chest compressions) if suitably trained.[1] If not suitably trained you are more likely to a) perform CPR and b) do it effectively if not providing mouth to mouth breathing.[2][3] You can argue about the nuance of particular patient groups where there is potentially a statistically significant benefit of providing conventional CPR over compression only.

Under no circumstances are there benefits to providing rescue breaths without chest compressions (as your comment seems to recommend).

[1]: https://pubmed.ncbi.nlm.nih.gov/21273279/ [2]: https://pubmed.ncbi.nlm.nih.gov/7726702/ [3]: https://pubmed.ncbi.nlm.nih.gov/17420082/

I think it was a while ago down a rabbit hole from the "Kiss of Life" picture talking about respiratory arrest. However, I can't find a substantiated source anymore so I will absolutely defer to your sources.

> Many modern AED's can be used by untrained people, so if you see a cardiac arrest, find the nearest AED and deliver it and/or follow its (brief) instructions.

AEDs are specifically designed to be used by untrained people.

Don't bother doing anything with ventilation unless it's a pediatric patient who arrested specifically because of an airway issue (foreign body, near-drowning). We (EMS) will ventilate with high flow oxygen and intubate on our arrival, but even for us, it still comes a distant second to compressions and electricity.

With adults, blood can remain sufficiently oxygenated for cellular respiration/metabolism for about 8 minutes of compressions. Survival rates for adult CPR as a rough average go down about 10% for every minute of compressions required.

What's the fastest way to find the nearest AED?

At least where I live, it's a requirement in order to operate a business. If you go anywhere and ask for their AED and they don't have one they can be shut down.

In the UK, many old phone boxes have been converted to house defibrillators:

[0]: https://www.independent.co.uk/news/uk/home-news/red-phone-bo...

[1]: https://www.communityheartbeat.org.uk/convert-phone-box

There's an app for that: https://www.pulsepoint.org/download

Depending on your country the GoodSAM app potentially has good mapping/coverage of AED locations: https://www.goodsamapp.org/aed

In most countries, by asking the emergency dispatcher when you call for an ambulance. Start chest compressions, get someone to call for an ambulance, then worry about finding an AED.

As far as I can tell, many modern CPR classes dropped the breath part. Just focus on the chest part.

Sort of. CPR classes are divided into, at least, "CPR" and "BLS". Your basic CPR class may be a hands-only training, but the BLS classes still include rescue breathing and AED use, along with infant care.

Took a BLS course in the last year in the US (PNW)... they barely covered breathing. I'm not actually sure, from taking it, when I would do breathing. They did a lot on the AED. I should re-watch the video.

Ah. I have a current AHA BLS cert. My understanding is, do breathing if you think there is a clear airway, and you have the appropriate PPE depending on the fluids on/around the person's mouth, and either you are doing compressions because there is no pulse or there is a pulse but the person is not breathing on their own. If you do choose to do rescue breathing, it's important to watch for chest rise to ensure that you're not breathing into their stomach, which is ineffective and will induce vomiting if the person regains consciousness.

There is a decision tree there that some people may be uncomfortable with in an emergency.

I welcome corrections from people with better training than mine.

I renew my AHA BLS cert every other year as a requirement for my EMT certification. You do breathing when you have a second rescuer available to do compressions.

I just did my cert in the PNW this month - there was plenty of time spent on breathing, but also emphasis that doing compressions is the important part. Interestingly, the instructor thought this change was mostly due to amateurs being far less comfortable with giving breaths and being likely to refrain from CPR altogether if they thought it was necessary to do the breathing.

FWIW I have done it by video during covid and in a live class before and after, and I did find it much more engaging and memorable in person. It was surprising to realize that, but simply having the additional sense memories seems to have made a big difference to retaining the information.

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